tice Points; USG Ultrasonography; WHO World Health Organization. How to cite this article Javeri Y, Jagathkar G, Dixit S, Chaudhary D, Zirpe KG, Mehta Y, et al. Indian Society of Critical Care Medicine Position Statement for Central Venous Catheterization and Management 2020. Indian J Crit Care Med 2020;24(Suppl 1)S6-S30. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.How to cite this article Farhad Kapadia. Suggestions and Commentary on Creating, Interpreting and Using Clinical Practice Guidelines. Indian J Crit Care Med 2020;24(Suppl 1)S2-S5. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.How to cite this article Kulkarni AP. Let there be Guidance!!!. Indian J Crit Care Med 2020;24(Suppl 1)S1. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Extrapulmonary tuberculosis (TB) involving bone marrow can present with various manifestations, including pancytopenia, maturation arrest, hemophagocytic lymphohistiocytosis (HLH), or infiltration of the bone marrow by caseating or noncaseating granulomas causing reversible or irreversible fibrosis. Tumor lysis syndrome (TLS) is an oncologic emergency resulting from massive tumor cell lysis. Children with TB with bone marrow involvement may also present with laboratory features of TLS resulting from high catabolism and concomitant acute kidney injury (AKI), making the diagnosis difficult at times. We present a case of disseminated TB who presented to emergency with pancytopenia, AKI, and laboratory features of TLS. How to cite this article Swami V, Lalitha AV, TK Anjan kumar. https://www.selleckchem.com/products/ON-01910.html Tuberculosis and Tumor Lysis Syndrome-Coincidence or Coexistent A Case Report. Indian J Crit Care Med 2020;24(2)145-147. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by a arbovirus. It is asymptomatic in infected animals but a serious threat to the health of individuals. In human, it starts with nonspecific febrile diseases and progresses into severe hemorrhagic syndrome with high-casual fatality. Here, we report a case of CCHF with atypical presentation of ascending paralysis and rhabdomyolysis. How to cite this article Prasad HR, Sharma A, Kothari N, Vyas V, Goyal S. Atypical Presentation of Crimean-Congo Hemorrhagic Fever as Ascending Paralysis with Rhabdomyolysis. Indian J Crit Care Med 2020;24(2)143-144. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Both subarachnoid hemorrhage (SAH) and acute pancreatitis (AP) are associated with systemic inflammatory response leading to extracerebral multiple organ dysfunction. In this case report, we describe an adult male, who developed AP in the postoperative period following surgical clipping of an anterior communicating artery aneurysm. The diagnosis of pancreatitis got delayed because the patient showed signs of systemic inflammation which would also been seen following SAH. How to cite this article Goyal A, Krishnakumar M, Radhakrishnan M, Srinivas D. Acute Pancreatitis in a Patient with Subarachnoid Hemorrhage A Causal Link or a Mere Coincidence? Indian J Crit Care Med 2020;24(2)141-142. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.We present a case of dengue with refractory thrombocytopenia who developed cerebral venous thrombosis (CVT) with intraparenchymal hemorrhage warranting surgical decompression. Patient was concluded to have secondary immune thrombocytopenic purpura (ITP) which remained refractory to high dose steroids, IVIg therapy, but responded to thrombopoietin receptor (TPO-R) agonist, eltrombopag. How to cite this article Sharma M, Chandan GS, Arayamparambil PV, Gopalakrishna UK. Case of Near Fatal Massive Intracerebral Bleed Secondary to Cerebral Venous Thrombosis in a Patient with Dengue and Refractory Thrombocytopenia. Indian J Crit Care Med 2020; 24(2)138-140. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Checking responsiveness is the mainstay in cardiopulmonary resuscitation (CPR). It is rare in the clinical situation when the patient requires resuscitation despite the presence of wakefulness. We report a case in which the patient presented with flat arterial line and absence carotid pulse while he was awake. A thorough literature review will also be discussed. How to cite this article Asghar A, Salim B, Tahir S, Islam F, Khan MF. Awareness during Cardiopulmonary Resuscitation. Indian J Crit Care Med 2020;24(2)136-137. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) are the group of disorders that are commonly presented as neuromuscular weakness in intensive care unit (ICU) settings. They are responsible for prolonged ICU stay and failure to wean off from mechanical ventilation. We report a case of young female who was admitted with undiagnosed type I diabetes mellitus with diabetic ketoacidosis, severe hypokalemia, sepsis developed acute onset quadriplegia, and diaphragmatic palsy within 72 hours of ICU admission. On detailed investigation, CIPNM was diagnosed. In view of high morbidity, mortality, and poor prognosis, a guided approach to diagnose and treat in earliest possible duration might give better improvement and outcome of the illness. Despite all the odds, our patient showed good clinical improvement and finally got discharged. How to cite this article Mahashabde M, Chaudhary G, Kanchi G, Rohatgi S, Rao P, Patil R, et al. An Unusual Case of Critical Illness Polyneuromyopathy. Indian J Crit Care Med 2020;24(2)133-135. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Objective The aim of this study was to measure the effects of a bundle of interventions in children admitted with severe sepsis or septic shock in the first hour after diagnosis on mortality. Materials and methods A retrospective study was conducted at a pediatric intensive care unit (PICU) between January 2014 and January 2016. Three interventions (intravenous [IV] antibiotic, fluid boluses, and vasopressor administration) applied in the first hour of severe sepsis or septic shock diagnosis were analyzed according to their adherence rates. The main outcome was mortality. Odds ratios were calculated. Results Of a total of 530 PICU admissions, 105 patients met the criteria for sepsis, 53 (50.5%) with severe sepsis and 52 (49.5%) with septic shock. Seventy-two (68.6%) patients received IV antibiotic within the first hour, 65 (61.9%) received IV fluid bolus, and 55 (53.3%) received a vasopressor drug. Fifty-two (49.5%) patients received concomitant IV antibiotics and fluid bolus. Blood cultures were collected before IV antibiotic administration in 87 (82.